Fungal Detection Methods
Overall, in 17 children (50%) multiple fungal species were detected. In twelve cases (35%) identification of fungal pathogens relied solely on histopathology and fungal cultures. Panfungal PCR, which was first introduced in our institution in 2011, was utilized in the remaining 22 patients (65%). PCR detected fungal pathogens in four patients with negative cultures, and additional fungal species in four patients with positive cultures (18% of patients tested by PCR). Overall, the use of panfungal PCR resulted in a change in antifungal therapy in 8 patients (36% of patients tested by PCR).
The most common fungus identified was Aspergillus in 20 patients (59%). Fifteen fungal pathogens of the order Mucorales were detected in 12 patients (35%), including Mucor (n=6), Rhizopus (n=7) and Absidia (n=2). Other pathogens included Alternaria(n=6), Exserohilum (n=6), Curvularia (n=3),Fusarium (n=3) and Candida (n=2).